Anesth Prog. 2024 Sep 9;71(3):109-114. doi: 10.2344/998301.
Dilution of concentrated epinephrine prior to intravenous use during clinical emergencies can delay urgent interventions. The objective of this study was to determine whether diluted epinephrine remains stable and sterile over time in common hospital settings.
Epinephrine samples were prepared by clinically relevant double dilution techniques. Samples were stored in 10-mL syringes and incubated under 1 of 4 simulated hospital environments with a mixture of lighting and temperature settings: 4°C/20°C, with or without fluorescent lighting. Samples were incubated for 0, 15, 30, 60, or 90 days. Capillary zonal electrophoresis was used to quantify the concentration of epinephrine and/or presence of any degradation products. All samples were tested for the presence of bacterial growth using blood agar cultures.
Diluted epinephrine samples remained stable for up to 90 days in all 4 simulated clinical storage conditions. No bacterial colony-forming units were detected in any of the environmental samples regardless of incubation duration, light, or temperature conditions.
Diluted epinephrine for anticipated clinical emergencies may remain clinically useful for up to 90 days, thus improving patient safety, access to medications, and overhead costs by reducing waste.
在临床急救中,静脉使用前将肾上腺素浓缩液稀释可能会延迟紧急干预。本研究旨在确定在常见医院环境中,稀释的肾上腺素在多长时间内保持稳定和无菌。
通过临床相关的双重稀释技术制备肾上腺素样本。将样本储存在 10 毫升注射器中,并在模拟医院环境的 4 种混合光照和温度设置下孵育:4°C/20°C,有或没有荧光灯。样本孵育 0、15、30、60 或 90 天。使用毛细管区带电泳定量测定肾上腺素的浓度和/或是否存在任何降解产物。使用血琼脂培养物测试所有样本是否存在细菌生长。
在所有 4 种模拟临床储存条件下,稀释的肾上腺素样本在长达 90 天内保持稳定。无论孵育时间、光照或温度条件如何,在任何环境样本中均未检测到细菌菌落形成单位。
预计用于临床紧急情况的稀释肾上腺素在长达 90 天内可能仍然具有临床用途,从而通过减少浪费提高患者安全性、药物获取和间接成本。